Healthcare Provider Details

I. General information

NPI: 1851063713
Provider Name (Legal Business Name): OANA CIOABLA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 E MARKET ST STE G
LEESBURG VA
20176-4172
US

IV. Provider business mailing address

14377 CEDAR KEY LNDG
CENTREVILLE VA
20121-5722
US

V. Phone/Fax

Practice location:
  • Phone: 703-669-8600
  • Fax:
Mailing address:
  • Phone: 571-524-4532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401417653
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: